In canal wall up (intact canal wall) mastoidectomy for cholesteatoma, the most significant advantage over canal wall down surgery is:

• A Lower recurrence rate of cholesteatoma
• B Easier access to the facial nerve
• C Less risk of sensorineural hearing loss
• D Better hearing outcomes and no cavity maintenance required ✓

Explanation

Canal wall up mastoidectomy preserves the posterior canal wall, maintaining normal ear canal anatomy, which means no mastoid cavity is created and therefore no regular cavity care is required. Hearing outcomes are better as the middle ear space is preserved. The significant disadvantage is a higher rate of residual or recurrent cholesteatoma (up to 30%), necessitating planned second-look surgery. It does not offer easier facial nerve access.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.